A pedestrian was hit by his wife’s car. The act was intentional. Car insurance rejected claims to repair her vehicle and also rejected claims for injuries. Is there any means to seek restitution?
Insurance policies do not cover intentional acts; however, while it is possible to have coverage for what initially appears to be an intentional act but turns out to be a negligent act, coverage for claims between spouses living together will be excluded.
In order for an automobile collision to be determined an intentional (rather than negligent), one must prove that the vehicle operator was thinking that he/she intended to cause harm the other spouse at the time of the act. We do not know what someone else is thinking at the time of an act. Although someone might think an act was intentional, it is possible that the vehicle operating spouse’s story to the insurance company, police, district attorney, and even the Court would suggest that the accident was unintentional, especially if the vehicle operating spouse is trying to avoid criminal prosecution for the collision causing harm to the other spouse. Thus, the injured spouse might still have a possibility to make a claim against the insurance carrier because it is impossible to prove whether the vehicle operating spouse intended to cause harm to the other spouse at the time of the collision.
Nevertheless, most insurance policies will specifically exclude coverage for a claim brought by one spouse who co-habitats with another spouse as there is too much possibility for collusion to ensure the validity of claims between spouses despite the merits of the case.
So, what can the injured spouse do to get compensated if the act was intentional? Well, the injured spouse can seek payment of medical expenses from Victims of Crimes. This is a fund by the State to provide money for medical expenses incurred by victims of criminal acts.
Additionally, if there is medical payments coverage, then the injured spouse may possible be entitled to that coverage to pay for medical expenses incurred. However, one would need to examine the policy to determined whether or not there is exclusionary language in the policy is in both spouses’ names.
Also, if the spouses are preparing for dissolution of marriage, then the injured spouse may want to proceed with a suit against the other spouse even if there is not coverage in order to obtain a judgment which will go against his/her separate property (1/2 of the community property to be divided in a dissolution). This may help the injured spouse in dividing assets more equitably.
Hence, when examining a claim for automobile collision personal injuries, because it is difficult to know exactly what is in the vehicle operator’s mind when the collision occurs, it may not be determinable that the collision was the result of an intentional act. As such, it is possible that coverage can be afforded for what initially appears to be an intentional act because it is not possible to prove that the vehicle operator acted with the requisite intent to cause harm in order for the act to be found intentional rather than negligent. But, just because it cannot be proven that your spouse intended to strike you with the car, it does not mean that the carrier will not ultimately be able to avoid paying. By and large, carriers exclude claims between spouses who are living together.